There are four levels of care that a Hospice agency provides. These levels of care are based on the intensity of care, length of care, and the location of the care provided. The first level is the Routine Home Care for individuals receiving hospice in their home. The rate does not vary by volume or intensity of service.
The second level is Continuous Care also received in the patient’s home, but for a period of at least eight hours within a 24 hour period beginning at midnight. This is only for brief periods of crisis and only as a necessity to maintain the patient in the home setting. Crisis defined by the Oklahoma rules and regulations of hospice means an event in which a RN, through direct assessment of a patient, determines that the patient is in need of Physician intervention and continuous care to achieve management of medical symptoms. Peaceful symptom-controlled-death is an expected patient outcome and is not considered a medical crisis by the Oklahoma-Hospice Act.
Respite Care, is the third level, it can be provided through an inpatient hospice unit, a hospice house, a nursing home, at home, or an acute care hospital that has dedicated hospice beds. This care lasts no more than five days at a time and is primarily for the families or the caregivers. If the ill person is being cared for at home, hospice will provide care of the patient while family/caregivers are able to have a break from constant care. At times, the patient will be admitted to an inpatient facility while the family has a much needed rest, this often happens when the caregiver has limited help with there loved one and is just in need of sleep, to better care for themselves and loved one’s later. Respite care can be used for when a family or caregiver may wish or needs to go on a sudden trip and the patient is not able to participate in the travel.
Last is General Inpatient Care that may be provided in a Medicare-certified hospital, skilled nursing facility, or inpatient unit of hospice. This is used for acute episodes of uncontrolled symptoms that are unable to be managed in the home or residency of the patient by the hospice team and therefore sent by the hospice to the inpatient facility. Most hospices continue to visit patients and work in conjunction with the facility to help manage the uncontrolled symptoms and return them to the home environment as quickly as possible. This part of the hospice care has been confusing in the past for patients, families, as well as some hospices and hospitals. I must say that hospitalization is not the preferred mode of treatment for hospice; it is about letting someone who has made the choice to stay home, stay at home. To be honest it is not sending the patient to the hospital or paying for it that bothers most hospices, it’s the pure fact that most of the time we feel as if we have let the patient/families down by not controlling their symptoms at home, which is our goal.
If you have any questions about this topic or hospice in general, contact us at 580-875-3975 or toll free 1-866-279-3975 or come by 112 N. Broadway in Walters.